학술논문
P59 SPONTANEOUS RESTORATION OF STABLE SINUS RHYTHM FOLLOWING EDGE–TO–EDGE TRANSCATHETER MITRAL REPAIR PROCEDURE WITH MITRACLIP IN A PATIENT WITH CHRONIC ATRIAL FIBRILLATION
Document Type
Article
Author
Source
European Heart Journal Supplements: Journal of the European Society of Cardiology; May 2023, Vol. 25 Issue: 1, Number 1 Supplement 4 pD61-D62, 2p
Subject
Language
ISSN
1520765X; 15542815
Abstract
Patients with history of atrial fibrillation (AF) undergoing mitral edge–to–edge repair procedure with Mitraclip tend to be relatively older, have more advanced valve disease, and suffer from more comorbidities than patients without AF [1;2]. Moreover, their all–cause mortality rate one year after the procedure and hospitalization rate for heart failure is higher than that of patients in sinus rhythm [3]. Therefore, managing patients with AF poses a greater challenge, and their prognosis is considerably worse. Improvement of mitral regurgitation following mitral edge–to–edge repair procedure with Mitraclip may reduce atrial volume overload positively impacting AF triggers. In this report, we present a case of spontaneous restoration of stable sinus rhythm in a patient with chronic AF undergoing mitral valve repair procedure with Mitraclip. The patient, 80 years old, underwent implantation of a clip on centro–lateral site of the mitral valve plane (A2–P2) with mild residual insufficiency and an optimal procedural result. The restoration of sinus rhythm, which occurred during the first hours after the procedure, proved to be stable at the 30th day control post–discharge. the indexed left atrial volume remained unchanged (LAVI 43–45 mL/m2). Literature on the frequency of spontaneous sinus rhythm restoration following edge–to–edge mitral repair with Mitraclip in patients with chronic AF is limited. In a sub–analysis of the COAPT study [4], in addition to the known benefits of the Mitraclip procedure, it was possible to highlight a significant reduction in the rate of stroke in patients with AF. This outcome could be attributed to the reduction of the AF burden associated with mitral valve insufficiency. More studies are although necessary to determine the procedure‘s impact in this specific clinical situation. Rreferences: [1] Velu JF, Am J Cardiol. 2017 Dec 1;120(11):2035–2040. [2] Saad AM, Catheter Cardiovasc Interv. 2021 May 1;97(6):1252–1256. [3] Shah S, Heart Fail Rev. 2021 May;26(3):531–543. [4] Gertz ZM, Circ Cardiovasc Interv. 2021 Apr;14(4):e010300.